Prostatic inflammation is associated with benign prostatic hyperplasia rather than prostate cancer

U. Falagario 1, O. Selvaggio 1, G. Carrieri 1, E. Barret 2, F. Sanguedolce 3, L. Cormio 1

1 Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy; 2 Department of Urology, Institut Montsouris, Paris, France; 3 Section of Pathological Anatomy; Department of Clinical and Experimental Medicine, University of Foggia, Italy

Background and aims. The relationship between prostatic inflammation, benign prostatic hyperplasia and prostate cancer is controversial. The present study aimed to determine the relationship between grade and aggressiveness of prostatic inflammation and the risk of being diagnosed with prostate cancer. 

Methods. Grade and aggressiveness of prostatic inflammation were assessed by Irani G and A scores, respectively, in prostate biopsy specimens of men having undergone this procedure because of increased serum PSA and/or digital rectal examination. We also assessed the correlation between Irani G and A scores and clinical variables related to benign prostatic obstruction. 

Results. Of the 1178 eligible patients, 615 (52.2%) were diagnosed with PCa; they were older, had greater PSA, suspicious digital rectal examination and peak flow rate but lower post-void residual urine volume, prostate volume and international prostate symptoms score than those without cancer. High-grade inflammation (Irani G 2-3) was significantly more common in patients with benign prostate than in those with PCa and the same applied to highly aggressive inflammation (Irani A 2-3). Indeed, patients with high-grade inflammation had greater PSA, prostate volume, post-void residual and international prostate symptoms score, suggesting high-grade inflammation to correlate with benign prostatic obstruction. Highly-aggressive inflammation conversely correlated only with prostate volume.

Conclusions. Prostatic inflammation seems to be associated with benign prostatic hyperplasia rather than prostate cancer, with benign prostatic obstruction being strictly linked to the degree of inflammation. 

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